摘要
目的探讨超声引导菱形肌-肋间肌-低位前锯肌平面阻滞(RISS)和胸椎旁神经阻滞(TPVB)对胸腔镜肺叶切除术后麻醉恢复质量的影响。方法选取2020年5月-2021年5月在本院全麻下行胸腔镜肺叶切除手术的64例患者为研究对象,并将以上患者随机等分为不同的两组。对照组患者行TPVB,研究组行超声引导RISS。对比观察两组患者术后不同时间段的静息与活动时VAS疼痛评分,术后镇痛和恢复情况,手术情况以及并发症概率。结果静息与活动状态下,两组患者在术后2h、4h、12h、24h以及48h的VAS疼痛评分均无统计学差异(P>0.05)。研究组患者的术后舒芬太尼用量更少,术后进食时间、下地时间及住院时间均比对照组更短(P<0.05)。研究组患者超声定位、穿刺以及操作总时间均短于对照组,并且穿刺针深度较浅,差异有统计学的意义(P<0.05),两组患者的注药时间无统计学差异(P>0.05)。研究组患者具有相对更低的并发症概率(P<0.05)。结论对胸腔镜肺叶切除手术的患者,超声引导RISS较TPVB对患者术后麻醉恢复质量有更为积极的影响,值得推广。
Objective To investigate the effect of ultrasound-guided rhomboid-intercostallow serratus anterior plane block(RISS)and thoracic paravertebral block(TPVB)on the quality of anesthesia recovery after thoracoscopic lobectomy.Methods A total of 64 patients who underwent thoracoscopic lobectomy under general anesthesia in our hospital from May 2020 to May 2021 were selected as the research subjects,and the above patients were randomly divided into two groups.The control group received TPVB,and the study group received ultrasound-guided RISS.The VAS pain scores at rest and during activity,postoperative analgesia and recovery,surgical conditions and the probability of complications were compared between the two groups of patients.Results There was no significant difference in the VAS pain scores between the two groups at 2h,4h,12h,24h and 48h after the operation between the resting and active states(P>0.05);the postoperative sufentanil dosage of the patients in the study group less time,postoperative eating time,time to get off the ground,and hospital stay were shorter than those of the control group(P<0.05).There was statistical significance(P<0.05),and there was no statistical difference in the injection time between the two groups(P>0.05);the patients in the study group had a relatively lower probability of complications(P<0.05).Conclusion For patients undergoing thoracoscopic lobectomy,ultrasound-guided RISS has a more positive impact on postoperative anesthesia recovery quality than TPVB,which is worthy of promotion.
作者
李华天
LI Huatian(Department of Anesthesiology,Maoming Hospital of Traditional Chinese Medicine,Maoming,Guangdong 525000)
出处
《智慧健康》
2022年第31期155-158,162,共5页
Smart Healthcare
关键词
菱形肌-肋间肌-低位前锯肌
平面阻滞
胸椎旁神经阻滞
胸腔镜手术
肺叶切除
麻醉恢复
Rhomboid-intercostal muscle-lower serratus anterior
Plane block
Thoracic paravertebral nerve block
Thoracoscopic surgery
Lobectomy
Anesthesia recovery
